Erotomania is also called de Clerambault's syndrome, after the French psychiatristGaëtan Gatian de Clerambault (1872 - 1934) who published a comprehensive review paper on the subject (Les Psychoses Passionelles) in 1921.

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Early references to the condition can be found in the work of Hippocrates, Erasistratus, Plutarch and Galen. In the psychiatric literature it was first referred to in 1623 in a treatise by Jacques Ferrand (Maladie d'amour ou Mélancolie érotique) and has been variously called "old maid's psychosis", "erotic paranoia" and "erotic self-referent delusions" until the common usage of the terms erotomania and de Clerambault's syndrome.

Berrios and Kennedy (see references) have outlined several periods of history through which the concept of erotomania has changed considerably:

Classical times – early eighteenth century: General disease caused by unrequited love

The core of the syndrome is that the affected person has a delusional belief that another person, usually of higher social status, is secretly in love with them. The sufferer may also believe that the subject of their delusion secretly communicates their love by subtle methods such as body posture, arrangement of household objects and other seemingly innocuous acts. The object of the delusion usually has little or no contact with the delusional person, who often believes that the object initiated the fictional relationship.

Occasionally the subject of the delusion may not actually exist, although more commonly subjects are media figures such as popular singers, actors and politicians. Erotomania has been cited as one cause for stalking or harassment campaigns. The assassination attempt of Ronald Reagan by John Hinckley, Jr. was reported to have been driven by an erotomanic delusion that the death of the president would cause actress Jodie Foster to publicly declare her love for Hinckley.

Late night comedian David Letterman and retired astronaut Story Musgrave were the targets of delusional Margaret Mary Ray, and other celebrities, such as Madonna, Steven Spielberg, Barbara Mandrell, and Linda Ronstadt also have been targets of stalkers suffering from erotomania.

The term erotomania is sometimes used in a less specific clinical sense meaning excessive pursuit of or preoccupation with love or sex.